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Posting Date: 04/04/2023
Billing and Coding: Ranibizumab, Aflibercept and Brolucizumab-dbll and Faricimab-svoa
Billing and Coding: Ranibizumab, Aflibercept and Brolucizumab-dbll and Faricimab-svoa eye, ophthalmology, macular A52451 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52451 C9399, J0177, J0178, J0179, J2777, J2778, [...]
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Posting Date: 07/02/2025
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 07/02/2025
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line
Know Your Provider Enrollment Revalidation Due Date Today and Protect Your Bottom Line Attention: Provider Enrollment and Credentialing Departments Revalidate before your due date to avoid a “Stay of Enrollment” or claim rejections which may [...]
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Posting Date: 11/04/2015
Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay
Three-Day Qualifying Hospital Stay Required for Medicare-Covered SNF Stay Medicare coverage of inpatient SNF services requires a qualifying, medically necessary inpatient hospital stay of at least three consecutive calendar days within 30 [...]
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Posting Date: 07/03/2025
MLN Connects® Newsletter: July 3, 2025
MLN Connects® Newsletter: July 3, 2025 Proposed Payment Rules ESRD: CY 2026 Proposed Rule — Submit Comments by August 29 Home Health: CY 2026 Proposed Rule — Submit Comments by August 29 News CMS Launches New Model to Target Wasteful, [...]
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Posting Date: 07/03/2025
Medicare Secondary Payer: A Review of the Non-Group Health Plan MSP Provisions
In this webinar, we review the workers’ compensation, No-Fault (including medical-payment coverage) and the Liability Medicare Secondary Payer (MSP) provisions. Understanding these provisions will help your facility identify and bill the [...]
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Posting Date: 07/03/2025
Medicare Secondary Payer: Payment and Beneficiary Responsibility
In this webinar, we review how Medicare determines if an Medicare Secondary Payer (MSP) payment is due on a claim, how the MSP payment module determines the amount of an MSP payment, how coding reported on MSP claims can impact payment, and how [...]
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Posting Date: 07/03/2025
Medicare Secondary Payer: Adjustment Claims
In this webinar, we will review how to prepare and submit adjustments (Type of Bill XX7) to change processed or rejected claims for Medicare Secondary Payer (MSP)-related reasons. We discuss adjusting Medicare primary, MSP, and cost-avoided [...]
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Posting Date: 07/03/2025
Home Health Billing Coffee Break
Provider Outreach and Education is hosting a 30-minute coffee break to help answer your troublesome billing questions. This is a great opportunity to discuss areas of billing more in depth and review helpful guides and resources. Keep in mind [...]
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Posting Date: 09/16/2020
Appeal Status <7>
Appeal Status <7> When Appeal Status is selected, the IVR will request and collect the following information: NPI PTAN TIN HICN or MBI Refer to the Phonetic Alphabet for assistance with speaking alpha characters [...]
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Posting Date: 07/08/2025
Request an Immediate Recoupment
National Government Services has implemented a standardized “immediate recoupment” process that gives you the option to avoid interest from accruing on claims overpayments when the debt is recouped in full prior to or by the 30th day from the [...]
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Posting Date: 07/08/2025
Complete a Voluntary Refund
A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible, the refund to Medicare should be [...]
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Posting Date: 07/08/2025
Set Up an Extended Repayment Schedule
If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]
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Posting Date: 12/19/2016
Payment Withholding Information
Payment Withholding Information What Is a Payment Withholding? Why Are Payments Withheld? Who Can I Contact for Further Assistance? What About Cost Report Interim and Final Settlement Withholdings? What Is a Payment Withholding? An [...]
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Posting Date: 07/08/2025
MSP Post-Pay Adjustments
If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the Part A voluntary refund form. A separate refund form is needed for [...]
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Posting Date: 12/19/2016
Refunds Due to Beneficiaries by Providers
Refunds Due to Beneficiaries by Providers In some situations, providers are responsible for refunding monies to beneficiaries that have paid for services providers have determined to be noncovered and nonpayable by Medicare. When an ABN has [...]
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Posting Date: 07/08/2025
Credit Balance Reporting
Table of Contents What is a Credit Balance? What Should I Do When I Have a Credit Balance? Additional Tips for a Successful Credit Balance Report Submission [Return to Top] What is a Credit Balance? Generally, when a provider [...]
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Posting Date: 02/04/2021
CMS-855I Completion Tips for Physicians and NPPs in Private Practice Revalidation Application
CMS-855I Completion Tips for Physicians and NPPs in Private Practice Revalidation Application Follow the instructions printed on the CMS-855I application and refer to this list of sections required for revalidation. Section Required [...]
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Posting Date: 10/20/2021
Cognitive Assessment
Cognitive Assessment Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99483: 60 minute face-to-face [Return to Top] Billing Information Cognitive assessment [...]
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Posting Date: 11/01/2021
Transitional Care Management
Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]
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